The Miller School at the 2025 American Diabetes Scientific Sessions
Summary
- Diabetes researchers from the University of Miami Miller School of Medicine’s Division of Endocrinology, Diabetes and Metabolism participated in oral presentations and led debate discussions surrounding the latest developments in diabetes research and care at the American Diabetes Association Scientific Sessions.
- Dr. Bernal-Mizrachi discovered that deleting the 4E-BP2 protein in male mice reduced their risk of developing Type 1 diabetes.
- Dr. Matthias von Herrath joined a panel discussing two approaches to beta-cell therapy for Type 1 diabetes: encapsulated cells and naked cells.
Leading diabetes researchers from the University of Miami Miller School of Medicine’s Division of Endocrinology, Diabetes and Metabolism participated in oral presentations, chaired symposia and led debate discussions surrounding the latest developments in diabetes research and care at the recent American Diabetes Association (ADA) Scientific Sessions in Chicago.
“Our expertise continues to make headways on a national level,” said Ernesto Bernal-Mizrachi, M.D., professor of medicine and chief of the division. “We had a robust presence at the ADA session as we shared our research across various disciplines within diabetes and connected with our colleagues.”
Interventions and Treatments in Diabetes Beta Cells
Diabetes affects more than 38 million Americans, with minority populations most affected. Young people are also susceptible, with more than 350,000 younger than 20 diagnosed with diabetes. Type 1 diabetes, during which the immune system attacks insulin-producing beta cells, affects 1.7 million adults and more than 300,000 children in the U.S.
By using mouse models, Dr. Bernal-Mizrachi discovered that deleting the 4E-BP2 protein in male mice reduced their risk of developing Type 1 diabetes by preserving insulin-producing beta cells and weakening harmful immune responses.
“These mice showed better insulin secretion, fewer aggressive T cells and more protective regulatory T cells,” Dr. Bernal-Mizrachi said. “The findings suggest that targeting the 4E-BP2/eIF4E pathway could be a promising strategy for treating Type 1 diabetes.”
Matthias von Herrath, M.D., professor in the Division of Endocrinology, Diabetes and Metabolism and scientific director of the Diabetes Research Institute at the Miller School, joined a panel at the ADA sessions discussing two approaches to beta-cell therapy for type 1 diabetes. Encapsulated cells are protected from the immune system but face delivery challenges. Naked cells require immune suppression to survive.
“I hope to reinforce the importance of cross-disciplinary collaboration in advancing effective, cell-based therapies for Type 1 diabetes,” Dr. von Herrath said. “By sharing insights drawn from integrated models of research and development, I aim to encourage more deliberate prioritization of immune strategies that align innovation with clinical feasibility.”
Diabetes in Organ Systems
Diabetes also affects organ function. Joana Almaca, Ph.D., associate professor in the Division of Endocrinology, Diabetes and Metabolism at the Miller School, participated in a debate during the scientific sessions examining pancreatic islets. Dr. Almaca’s work examines how blood vessels facilitate the orchestration of nutrient sensing and hormone release from these endocrine mini-organs, which produce insulin and glucagon to regulate blood glucose levels. This vascular control tends to be compromised during the early stages of diabetes.
During the debate, Dr. Almaca and her colleague agreed that islet and exocrine blood vessels are connected. They disagreed on how this connection is controlled, with Dr. Almaca favoring an active and tightly regulated control over a passive one.
“We believe hormone release must be precise and timely, which requires active control,” Dr. Almaca said. “Our research shows that islet capillaries are covered by pericytes—tiny ‘gates’ that open or close based on signals from endocrine cells, nerves and blood vessel linings. This helps adjust blood flow to match the body’s needs, making pancreatic islets highly advanced, hormone-regulating units.”
David Baidal, M.D., assistant professor in the Division of Endocrinology, Diabetes and Metabolism at the Miller School, chaired a session that highlighted data regarding the use of sotagliflozin in patients with Type 1 diabetes in the inTandem 1 and 2 trials. The session showed how adding sotagliflozin to insulin therapy in adults with Type 1 diabetes significantly reduced the risk of clinically important hypoglycemic events at different levels of renal function.
With decline in renal function, the incidence of severe hypoglycemia increased. The use of sotagliflozin also demonstrated a reduction in severe hypoglycemia episodes across all levels of kidney function evaluated, although the difference was not statistically significant compared to placebo. The incidence of diabetes ketoacidosis (DKA) was reported to be very low, although percentages were higher in both sotagliflozin groups compared to placebo.
“This data shows the addition of sotagliflozin to optimized insulin therapy in patients with T1D can reduce the incidence of clinically important hypoglycemia events in the setting of reduced estimated glomerular filtration rate,” Dr. Baidal said. “However, the lowest mean eGFR evaluated in these analyses was 53.4 ml/min/1.73m2, and whether reductions in hypoglycemic events will also occur at a lower level of renal function remains to be determined. Although the incidence of DKA was low, this is a reminder for clinicians about the need for adequate implementation of protocols to mitigate DKA risk in patients with T1D on adjunctive treatment with sodium-glucose linked transporter inhibitors.”
Body Composition and Cardiovascular Risk
Body fat percentage (%BF) may be a more accurate measure of body fat and diabetes risk than body mass index, according to Rodolfo Galindo, M.D., associate professor in the Division of Endocrinology, Diabetes and Metabolism at the Miller School. However, there is limited research comparing %BF and BMI in people with and without diabetes.
Dr. Galindo’s presentation looked at data from the 2011-2018 National Health and Nutrition Examination Survey. The data consisted of adults older than 18 categorized into three groups:
• No diabetes (NoDM)
• Newly diagnosed diabetes (NewDM)
• Established diabetes (DM)
Among 22,560 participants, 82.4% had NoDM, 5.6% had NewDM and 12.1% had DM. Those in the DM group were older, on average.
“While BMI was similar between males and females within each group, body fat percentage (%BF) showed more pronounced differences, as females consistently had higher %BF than males,” Dr. Galindo said. “Cardiometabolic risks were highest in those with established DM. Overall, %BF revealed clearer distinctions across diabetes and sex groups than BMI, suggesting it may be a more effective tool for identifying diabetes risk.”
Dr. Galindo also chaired a symposium on ketone monitoring, innovations and clinical applications and presented three cardiovascular co-author presentations on Type 2 diabetes.
Tags: diabetes, Diabetes Research Institute, Division of Endocrinology Diabetes and Metabolism, Dr. David Baidal, Dr. Ernesto Bernal-Mizrachi, Dr. Joana Almaca, Dr. Matthias von Herrath, Dr. Rodolfo Galindo, islet cells, type 1 diabetes, type 2 diabetes